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General NPI Number Information
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NPI Number | 1003253857
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Entity Type | Individual
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Provider Name | ERICA RENE WILT M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/03/2013
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 11215 METRO PKWY STE 100
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City | FORT MYERS
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State | FL
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Zip | 33966-1206
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Country | US
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Telephone | 239-208-2206
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Fax |
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Provider Business Mailing Address
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Address Line | 624 QUAKER LN STE D201
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City | HIGH POINT
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State | NC
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Zip | 27262-3832
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Country | US
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Telephone | 336-781-4065
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Fax | 336-716-3202
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 2017-01913
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | U9107
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2024010304
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 35.150808
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD220714
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License Number State | OR
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD61551018
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License Number State | WA
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Taxonomy #7
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 98605
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME166086
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License Number State | FL
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Taxonomy #9
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME166086
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License Number State | FL
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